Who do you hire to help you when you have focus issues at work?

August 25, 2022 1:25 AM

I like my work-from-home desk job, but I seem to want to do anything except my work during the day. Many years of therapy have helped, and a couple years ago my doctor put me on an antidepressant, which helped too, but it's not enough.

I have difficulty doing solo work, good with meetings. By myself, I often feel like: I don't want to do my work, I don't know how to do it, I can't get started, there's too much to do, I'm not ready, and similar things. This is a problem I've had since I was a teenager, at varying levels of intensity at different times. It is confusing and frustrating, because I'm good at my job when I am able to do it. Therapists taught me some approaches that sort of help, sometimes, including ACT modality. Wellbutrin reduced the intensity but not the frequency. I've tried things like pomodoro and keeping a checklist on paper.

Outside work, my executive function is good. My most recent therapist (who I saw for a different specialty) and my GP agreed with me that ADHD does not seem to be a helpful description for me. I'd describe my work thing as an anxiety thing instead, some variety of gifted kid syndrome.

I don't know what would help. I thought about hiring a mentor, a more experienced person in my type of role at a different company who gives advice as a side job, but I don't think I need skill mentorship. I want somebody to help me get better at the practical aspects of focusing on my work, up for dealing with me even if I feel sad or overwhelmed. Do you have a recommendation for a person who works over videocall? Could be a therapist, a coach, or something else? I'm up for people who specialize in ADHD, if they're up for talking to somebody adjacent. I'm in California if it matters.

posted by mysh to Work & Money (9 answers total)

I believe people with ADHD* often benefit from having someone else in the room with them while they work. They don't have to be working on the same task, or even a related task, but having someone in the same space working alongside them helps anchor them to their task. So you could try that? I think it's known as Body Doubling.

If it works, there'd be a few options for making it sustainable longer term - go to a public space to work; find a friend or friends who can have a regular doubling arrangement where you work at one anothers' houses; look into using Focusmate, which pairs you with online doubles; rent a desk in a shared office space near home that's more convenient than a corporate office might be, but has other people around; decide that in-office jobs are better for you than work from home and set your future job searches accordingly.

*and indeed non-ADHD folk, but I think the idea originated from people with ADHD.
posted by penguin pie at 3:01 AM on August 25, 2022 [2 favorites]

FWIW I have ADHD and what you described is exactly one of my symptoms when I am unmedicated. Medicated, it becomes possible for me to begin which is all I ever needed to overcome this issue.

Since you don't think you have ADHD, I would suggest you focus on finding ways to begin.
posted by MiraK at 4:35 AM on August 25, 2022 [4 favorites]

I hope this is allowed here on Ask.MetaFilter, but I just published a guide on Medium yesterday that delves into the differences between coaching, mentoring and therapy, as seen through five different lenses (purpose, focus, method, approach, and outcomes). The goal is to allow you to make an informed decision about which path to take, which sounds like exactly what you're after.

It also sounds like you might be leaning toward finding a coach and if so, I'd recommend one specialises in productivity for people with ADHD. There are no shortage of those!
posted by iamkimiam at 4:51 AM on August 25, 2022 [4 favorites]

Body doubling is fashionable right now so if it works for you there are even creators on tik tok that run all day body-doubling lives.
posted by jeoc at 5:34 AM on August 25, 2022

If you'd like to do a little low-key experimentation with body doubling, something online friends and I do is little sprints where we all agree that, say, we're going to buckle down and get some work done for thirty minutes (or fifteen, or five!) together. Sometimes this could involve being on a video call together but more often it's just something we organize over text. But just having that commitment to a friend that for the next twenty minutes I'm going to stop fucking around on MeFi and start the thing I'm avoiding can be so helpful. Sometimes that push is enough to get me rolling, and even if it doesn't, at least I've done a little set-up work for future me. We might string a bunch of these sprints together or just do one, whatever works for the people involved and the things they need to do.
posted by Stacey at 6:44 AM on August 25, 2022 [1 favorite]

Hey there, I have a very similar problem, and like you I've also found it very difficult to find outside help for this problem. You are not alone! In my case, I think it's a combination of ADHD and anxiety/perfectionism/"gifted child syndrome". I definitely do have ADHD, but typical ADHD treatments have not totally resolved the issue for me. Here are some different things I've tried, in order from least to most successful:

• Working with an ADHD coach: I found her randomly online. The first few sessions were moderately successful just in helping me frame the issue and talk it through with someone who was fully understanding and non-judgmental; however, I didn't end up walking away with any strategies that helped me in the long term.
• Talking with a therapist: This was very helpful in terms of helping me feel less shame around this issue; he made me feel like lots of people have similar struggles and I wasn't alone, which helped me a lot emotionally. But he also couldn't really help with practical solutions that I hadn't already thought of myself.
• ADHD medication: This helped a lot for several months; it especially helped me with "getting over the hump" of getting started in the morning, which had a snowball effect on the rest of the day because once I was able to get a few things done in the morning it improved my self-esteem and made it easier to stay productive for the rest of the day. But after about 18 months I started to gain a tolerance to the meds and they weren't really helping me much anymore, so I've recently decided to cut back -- I take a smaller dose a few days a week which helps a little bit, but the rest of the days I'm on my own. I also drink several mugs of coffee per day.
• Sometimes it helps me to pretend like everything is a game, and I just need to press some buttons and get the highest score possible. This takes away some of the worst dread and help me takes things less seriously, which sometimes help me dig myself out of paralysis temporarily.
• Giving myself permission to do whatever seems fun, as long as it's marginally productive. I often get stuck between multiple tasks, where one is unsavory but more important/urgent, and the other one is less urgent but more fun. I've learned to take advantage of the snowball effect and just let myself work on the less urgent task, and then once I've already started working it's easier to use that motivation to carry me through the less savory task.
• Body doubling: Super helpful. I go into the office most days so that I have other busy people around me, and/or occasionally video chat with a friend of mine with similar issues. It often helps, but doesn't always pull me out of a spiral if I'm already in a rut.

That's just a few things off the top of my head; I might come back and add more later if I think of some. It's a tough problem and I see you -- bon courage!
posted by mekily at 7:20 AM on August 25, 2022 [5 favorites]

On the topic of "just start" I read Getting Things Done some years back and have relied very heavily on identifying the first tiny action I need to do and then doing *just that*. The way my strain of ADHD-alike anxious brain works, once I get hooked on a problem or into a flow it's easy to keep going, but the initial inertia or resistance is hard to overcome unless it starts with a very simple action that has no second-guessing possible.

For example, I need to reach out to consultants about a complex issue, but I can't focus on it. When I ask what the next action is, I notice I am going in circles about how to do it and should I tell them about problems B and C as well as problem A and what were we even going to get out of this ugh I'm gonna go get a coffee. So I say, ok, maybe the first thing is to open the email where my colleague described the problem and re-read that. I don't have to Solve The Everything, I just have to open the email. Then I read it and the request is usually not that complicated and now I'm thinking about the job (rather than thinking about "needing to do the job").

Another similar step that's commonly suggested as a "first step" for writing-type activities is to just sit down and open a blank document. "Log in and open my email" is a good one too, "I know you don't wanna, self, we don't have to tackle everything, let's just log in and at least open the email page."
posted by Lady Li at 8:13 AM on August 25, 2022 [2 favorites]

identifying the first tiny action I need to do and then doing *just that*

I do this too. Related to this, I think, is I make a to do list and work my way through it in order. It helps me with all of this: I don't know how to do it, I can't get started, there's too much to do, I'm not ready. I have a list, I do the next thing on the list. Specifically, I do the first tiny action of the next thing on the list. I don't think about what it is, how I'm gonna do it, how much I don't want to do it, how maybe I should do a different thing on the list instead. I just do the next thing on the list, no matter what it is.

And having other people around helps immensely. I didn't know that was a thing with a name.
posted by Mavri at 6:04 PM on August 25, 2022

Mod note: Final update from the OP:

Hello from a year later! I appreciated these answers, and I wanted to share what I tried and how it went. It's taken a lot of work and a lot of money, but I'm doing a bit better.

I worked with a coach for about six months. I initially found our work frustrating, but eventually we figured out a few things that helped, including using Todoist, Focusmate, and Focus@Will.

Then she suggested I start therapy again and work with my GP to get a neuropysch evaluation. My GP and I ruled out vitamin deficiencies and thyroid issues, and she referred me to a psychiatrist. I also started working with a new therapist.

At my intake appointment with the psychiatrist, I explained my weird confusing form of anxiety and he immediately started screening me for ADHD. I was annoyed but agreed to do ADHD testing.

Turns out that it can be helpful to see a trained person instead of self-diagnosing, who knew, and now I have a preliminary ADHD diagnosis. It's been tough to integrate this information, but it's helpful. I'll be trying an adjustment to my medication to see if that helps, and continuing to work with my providers on this.

posted by taz (staff) at 11:15 PM on October 6, 2023